# Identifying senescence and immune biomarkers predictive of benefit to combined CDK4 and checkpoint blockade inhibition in patients with dedifferentiated liposarcoma

> **NIH FDA R01** · SLOAN-KETTERING INST CAN RESEARCH · 2024 · $620,672

## Abstract

Few viable treatments exist for patients with locally advanced or metastatic well-differentiated or
dedifferentiated liposarcoma (WD/DDLS), which are rare and often neglected orphan cancers. There are
approximately 1000 patients per year in the US diagnosed with WD/DDLS, and these cancers generally do not
respond to chemotherapy. Recent trials of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, motivated by the
finding that the CDK4 gene is amplified in >90% of WD/DDLS, show these agents stabilize disease that had
been growing prior to treatment and demonstrated clinically meaningful median progression-free survival (PFS) of
66% at 12 weeks but responses were uncommon.
 To enhance response rates and improve PFS benefit, we propose to combine the CDK4/6 inhibitor
palbociclib with an antibody against the immune checkpoint PD1. Checkpoint inhibitors have some activity in
DDLS, leading to partial responses in about 8% of patients. CDK4/6 inhibitors have been shown to increase
the efficacy of checkpoint inhibitors and to promote antitumor immunity in breast cancer patients and animal
models. In responsive tumors, CDK4/6 inhibitors trigger senescence, causing cells to secrete proinflammatory
cytokines and growth factors (termed the senescence-associated secretory phenotype, or SASP), suggesting
that these agents may enhance antitumor immunity.
 To identify patients likely to benefit from this combination therapy, we will investigate mechanisms of
response and resistance using pre- and on-treatment biopsy specimens from patients on the proposed phase
2 trial of palbociclib combined with the anti-PD1 antibody INCMGA0012. These studies will focus on the
cellular markers previously determined to be required for CDK4/6 inhibitor-induced senescence in WD/DDLS
(MDM2 turnover, cadherin 18 expression); markers of terminal senescence (Angplt4), antitumor immune
responses; and gene expression. Thus, our Specific Aims are to: (1) Assess the safety and efficacy of CDK4
inhibition using palbociclib in combination with PD1 blockade using INCMGA0012 in 30 patients with
WD/DDLS (outcomes: overall response rate, PFS, and overall survival); (2) Examine the roles of senescence,
terminal senescence and resultant SASP in response to the combination therapy and, their relationship with
immune response; and (3) Characterize the immune microenvironment (specifically CD8+ T cells and PDL1+
tumor cells) and tumor gene expression (assessed with immunohistochemistry and both bulk and single-cell
RNA sequencing) prior to and during combined treatment of palbociclib and INCMGA0012, and examine their
association with clinical response and outcome.
 Successful completion of this trial may lead to the introduction of a novel combination immunotherapy
strategy for WD/DDLS and identify predictive biomarkers for selection of patients most likely to benefit in both
sarcoma and other malignancies.

## Key facts

- **NIH application ID:** 10834134
- **Project number:** 5R01FD007528-03
- **Recipient organization:** SLOAN-KETTERING INST CAN RESEARCH
- **Principal Investigator:** Sandra P D'Angelo
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** FDA
- **Fiscal year:** 2024
- **Award amount:** $620,672
- **Award type:** 5
- **Project period:** 2022-08-15 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10834134

## Citation

> US National Institutes of Health, RePORTER application 10834134, Identifying senescence and immune biomarkers predictive of benefit to combined CDK4 and checkpoint blockade inhibition in patients with dedifferentiated liposarcoma (5R01FD007528-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10834134. Licensed CC0.

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